Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Community Medicine, College of Health Sciences, University of Calabar, Calabar, Nigeria.
J Evid Based Med. 2020 Feb;13(1):17-24. doi: 10.1111/jebm.12374. Epub 2020 Feb 18.
The study aimed to assess the self-rated knowledge, attitude toward, and practice (KAP) of evidence-based medicine (EBM) among resident doctors in Nigeria.
This was a cross-sectional web-based survey among 238 resident doctors in four selected teaching hospitals in southern Nigeria. Survey questionnaire contained items assessing the KAP of EBM, familiarity with and understanding of key EBM terms, the use of EBM in decision making, barriers militating against EBM and ways to improve EBM adoption. Proportions and summary statistics were reported for the distribution of survey items.
Mean number of years in clinical practice was 9.3 ± 4.5 years. Respondents were uniformly distributed in major clinical specialties. The majority (70.5%) were senior registrars. Respondents' understanding of EBM components included; current best clinical evidence (98.3%), clinical expertise (65.5%), and patients' choices (36.6%). Self-rated familiarity with EBM terms was high while perceived understanding of the terms was lower. The least understood concept was heterogeneity (20.6%). The attitude toward EBM was generally positive. Only about half (53.6%) had used medical bibliographic databases within the last 6 months prior to the survey. Barriers against EBM included lack of time (47.1%) and lack of requisite skills (32.4%). Suggestions to improve EBM adoption included training (58.1%), provision of free Wi-Fi, and free access to bibliographic databases (25.2%) and increased political will (23.1%).
A further understanding of the EBM concept, provision of enabling infrastructure, regular clinical audit and advocacy to hospital management and clinical consultants, may improve the level of adoption of EBM.
本研究旨在评估尼日利亚住院医师对循证医学（EBM）的自我评估知识、态度和实践（KAP）。
这是一项在尼日利亚南部 4 家选定教学医院的 238 名住院医师中进行的横断面网络调查。调查问卷包含评估 EBM 的 KAP、对关键 EBM 术语的熟悉程度和理解、在决策中使用 EBM、阻碍 EBM 的障碍以及改善 EBM 采用的方法等项目。报告了调查项目分布的比例和汇总统计数据。
临床实践的平均年限为 9.3 ± 4.5 年。受访者在主要临床专业中均匀分布。大多数（70.5%）是高级住院医师。受访者对 EBM 组成部分的理解包括：当前最佳临床证据（98.3%）、临床专业知识（65.5%）和患者选择（36.6%）。自我评估对 EBM 术语的熟悉程度较高，而对术语的理解程度较低。最不理解的概念是异质性（20.6%）。对 EBM 的态度普遍较为积极。只有约一半（53.6%）在调查前的过去 6 个月内使用过医学文献数据库。阻碍 EBM 的因素包括缺乏时间（47.1%）和缺乏必要技能（32.4%）。改善 EBM 采用的建议包括培训（58.1%）、提供免费 Wi-Fi 和免费访问文献数据库（25.2%）以及增加政治意愿（23.1%）。
进一步了解 EBM 概念、提供使能基础设施、定期临床审核以及向医院管理层和临床顾问宣传，可能会提高 EBM 的采用水平。
